How common is an underlying pathology in men presenting with haematospermia?
BAUS ePoster online library. Satchi M. Jun 24, 2019; 259533; P4-4
Ms. Maria Satchi
Ms. Maria Satchi
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Abstract
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INTRODUCTION

Haematospermia can present in asymptomatic men and can be alarming. This raises the concern of an underlying pathological cause leading to multiple investigations. The aim of this study was to retrospectively evaluate the diagnostic yield of investigations for haematospermia and the incidence of underlying pathology.

METHODS

A retrospective review of 100 consecutive men who underwent investigations for a single or recurrent episode of haematospermia was performed in a single centre. Patient demographics, radiological and microbiological results were recorded together with the clinical outcomes.

RESULTS

The median age was 51 years (range 16-77 years). In this cohort, 10% were found to have a significant finding for which an intervention was proposed (prostate cancer n=2, mesonephric duct abnormality n=1, ejaculatory duct stones n=1, seminal vesicle (SV) dilatation n=4, renal stone n=1, abnormal MRI n=1). 4% were offered an SV washout for SV dilatation or blood. No significant findings were identified on renal and scrotal ultrasound or CT. Urine and semen cultures were positive in one patient (Klebsiella). A total of 76 patients underwent a TRUSS and 27 of these patients were found to have an abnormality (ejaculatory duct calcifications/debris n=13, midline prostate cyst n=7, SV dilatation/blood n=7). 83% did not require any follow up.

Conclusions
In this cohort only 10% of patients were found to have an abnormality. Apart from TRUSS the remaining investigations have a low diagnostic yield. Based on our results, we propose an algorithm for the management of haematospermia to limit unnecessary investigations with the majority requiring reassurance.

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